Mar 7, 2021

What you need to know about glaucoma with Dr. Marianne Edwards

This World Glaucoma Awareness Week we’re helping raise awareness by sharing valuable information about glaucoma and answering common questions surrounding symptoms, risk, and prevention. Keep reading to learn from ophthalmologist and glaucoma specialist Dr. Marianne Edwards.

Introduction: What is glaucoma?

Glaucoma is an eye diseases that affects over 400,000 Canadians. The most common types of glaucoma are open-angle, which is more prevalent and can go unnoticed due to a lack of early symptoms, and angle-closure, which can be painful with sudden onset. In both cases the eye’s drainage canals are blocked, leading to a build-up of fluid and increased intraocular pressure that damages the optic nerve and can lead to vision loss if untreated.

Q&A with Dr. Marianne Edwards

How do I know if I have glaucoma if I do not have any symptoms?

The best way to know if you have glaucoma is to have regular eye exams at least every 1-2 years. There are many different types of glaucoma and there are rare symptoms that can occur with more advanced cases such as blind spots in your peripheral (side) vision, headache, redness, pain in the eye or forehead, halos around lights or rainbows, nausea and/or vomiting. People with these symptoms should be checked by their eye care professional as soon as possible.

If glaucoma is related to high eye pressure, does my blood pressure matter too?

Blood pressure has an effect on glaucoma, but not in the way you might think! While we do know that the fluid pressure control system in the eye is largely independent of the blood pressure system, there are some indirect links. The links are complex, but in a nutshell, high intraocular fluid pressure leading to glaucoma can occur with normal, high, or even low blood pressure. We know that the site of damage to the eye from glaucoma is the optic nerve. High eye pressure damages the optic nerve, but so can high or low blood pressure by decreasing the blood flow and oxygen supply to the nerve.

The main point is that in a glaucoma patient, we like to ensure that the blood pressure is well controlled in order to maximally protect the optic nerve. Even though the pressure regulation systems are separate, we need normal eye pressure and normal blood pressure to best protect our optic nerve from glaucoma damage.

I have been diagnosed with glaucoma. Will I lose my vision?

Glaucoma continues to be one of the leading causes of blindness in the world. However, with current technological advances, we have made significant progress in our ability to treat glaucoma and prevent blindness. We are fortunate in Canada to have access to the most advanced screening and diagnostic tools available. Nowadays, if glaucoma is caught early, it is preventable and/or treatable in many cases. While it is a chronic condition that requires lifelong treatment, it is far less likely to cause blindness than it was in the past.

Is there a difference between brand name drops and generic drops?

This question continues to be a matter of debate. The main advantage of the generics is the lower cost. Most patients do just fine with generic formulations, but there are some exceptions. Generic drug manufacturers are generally required to demonstrate “equivalence”, which means their product must contain the same concentration of active ingredient as the brand formulation. However, there can be slight differences in the “fillers” like preservatives, pH adjusters, antioxidants, buffers, thickening agents, bottle shape and size, as well as drop delivery mechanism. For some patients, these differences can mean different side effects, pressure lowering, and compliance. Because of this, it is best to discuss the options with your eye care provider who can tell you about the specifics of the drop chosen for your glaucoma.

How do I know if my glaucoma is stable? What does it mean if my glaucoma keeps getting worse?

Because glaucoma has been labelled as a “silent thief of sight”, it is difficult, if not impossible, for patients to know if it is stable. The most important aspect of detecting progressive damage from glaucoma is follow ups with your eye care professional. Glaucoma can be tracked and followed accurately, and progression of damage can be identified by specialists long before it is noticeable by the patient. If you are told that the glaucoma is getting worse, it doesn’t necessarily mean that it can’t be halted or stabilized by a change in treatment. There are many different treatment regimens that can be effective, and these are improving over time.

If I do not have glaucoma but have an increased risk of developing it, are there any prevention measures I can take?

If you search this question on the internet, you will be bombarded with a variety of suggestions on how you can prevent glaucoma! However, the bottom line is that if you are at risk due to family history or otherwise, your best preventive measure is to have regular checkups with your eye care specialist in order to catch it early. There are only a few preventative measures that may reduce some of your risk. For example…

• Steroid medication of any type can be a risk factor for glaucoma, and it is important that you have an eye exam if you will be on a prolonged course of steroid.
• Eat plenty of leafy green vegetables and coloured fruits and berries each day.
• Exercise regularly, but carefully. Inverted head positions can greatly increase your eye pressure if prolonged. Certain yoga positions and fitness regimens with heavy weightlifting should be minimized or controlled for those at risk for glaucoma.
• General health measures such as maintaining normal blood pressure, avoiding smoking, treatment for obstructive sleep apnea, and wearing safety eye protection to avoid injury can all be helpful to prevent glaucoma onset.

Research certainly continues on glaucoma prevention; however, the single most important message is early detection by an eye care specialist.

If you have questions about glaucoma, connect with FBC’s Health Information Line at 1.888.626.2995 or by email healthinfo@fightingblindness.ca.

About Dr. Marianne Edwards

Dr. Edwards is an Ophthalmologist specializing in Glaucoma, and is an Associate Clinical Professor of Ophthalmology in the Department of Ophthalmology and Visual Sciences at the University of Alberta. She graduated from Medicine (BSc /MD) and an Ophthalmology Residency at the UofA, and completed a Glaucoma Fellowship in St. Louis, MO with Allan E. Kolker MD.

A Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC) since 2001, Dr. Edwards is also a member of numerous professional societies, including the Canadian and Alberta Medical Association, American Academy of Ophthalmology, American Glaucoma Society, Canadian Ophthalmological Society, and the Canadian Glaucoma Society. With almost 20 years of experience as a glaucoma specialist, Dr. Edwards is committed to training Fellows, Residents, and Medical Students at the University of Alberta, while providing her patients with the highest level of care. Dr. Edwards works closely as a team with the other Glaucoma Subspecialists in Alberta and Canada.